Editor's note: This story was originally published on Aug. 12, 2014.
LIMA, Peru — “Out of 10, when I smoke the pain is four. When I don’t, it is 14,” says Cecilia Heyder, a Chilean housewife with breast cancer and lupus who is likely the first person to be legally prescribed medical marijuana in Latin America.
“I feel like I am burning up inside. Everything hurts. I don’t have the strength to take a step, and I often have to use a wheelchair. My body rejects opiates so cannabis is the only thing that works for me.”
On June 26, Chile’s Institute for Public Health granted Heyder special permission, based on her unusual double illness, to be treated with Sativex, a cannabis-derived painkiller that will improve her quality of life — without getting her stoned.
The 48-year-old mother of two was diagnosed with systemic lupus in 2009 and then breast cancer in 2011. As the pain became unbearable, and on a doctor’s suggestion, she began using cannabis in early 2013.
With her first shipment of Sativex from the UK still weeks away, she now takes the soft drug through infusions, in food and by smoking joints.
None of that’s permitted by Chilean law, although possession of cannabis for personal use is not actually punished.
Sativex is cannabinoid medicine mouth spray. (GW Pharmaceuticals)
Before her illness, Heyder says, she had only ever tried the drug once, as a teenager, and did not enjoy the experience.
Her case appears to mark a watershed in a region where no nation, including Chile, yet has laws in effect that allow or regulate medical marijuana.
“It is a very significant step. This is the first time that the Chilean state formally recognizes the use of medicinal marijuana,” says Ana Maria Gazmuri, president of the Daya Foundation, which campaigns for alternative medicine in Chile.
It also puts Heyder right at the forefront of a growing push across Latin America to end the United States’ “war on drugs,” first declared by President Richard Nixon in 1971.
Part of that push includes a gathering momentum to use pot to treat the symptoms of a wide range of ailments, including cancer, AIDs, multiple sclerosis, Alzheimer’s, post-traumatic stress disorder and glaucoma.
In many of those illnesses, cannabis or pharmaceuticals derived from it are used as a palliative, to kill pain or relax a patient. But in some conditions, the drug can be used to stop other symptoms, such as epileptic seizures.
In a murky gray area on the fringes of Chilean law, Gazmuri’s foundation is using marijuana to help treat 20 youngsters, from 3 months to 17 years old, with epilepsy or similar conditions. Cannabis, she says, is the only medicine that stops their frequent and often dangerous fits.
Similar cases have also been documented in the United States, where medical marijuana is now permitted by 23 states and the District of Columbia. In one tragic recent case, a 9-year-old New York girl, Anna Conte, died last month as she waited for the new state medical marijuana program to finally get up and running.
Although overshadowed by its legalization of recreational weed, Uruguay’s high-profile new marijuana reform also paves the way for doctors there to prescribe pot or cannabis-derived treatments.
Yet Uruguayan lawmakers are still drafting the rules for medical marijuana and the first patients are not likely to begin treatment until the end of the year.
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Meanwhile, bills are being pushed in both the Colombian and Mexican congresses to allow it, as well.
The Colombian bill is the brainchild of Sen. Juan Manuel Galan, who blogged recently:
“Colombia has accumulated enough frustration in the face of failed strategies in the management of marijuana, and now is prepared to talk about the issue and seek new ways to improve the quality of life for all those who suffer terminal or chronic illnesses.”
Galan is himself one of many victims of the drug war. His father, Luis Carlos Galan, was assassinated during his 1989 run for president on orders from the cartel kingpin Pablo Escobar.
Back in Chile, Heyder’s breakthrough has prompted one political party, Amplitud, to propose a bill that would decriminalize growing grass at home for both recreational and therapeutic uses.
Interestingly, Amplitud is a center-right party. Few in Chile actually oppose the legalization of medical marijuana. One recent poll found 78 percent in favor.
The bill is just one of several now being debated in Chile that could also authorize the country’s public health care system to routinely incorporate cannabis-derived pharmaceuticals like Sativex into its inventory. At least one of those pieces of legislation is widely expected to sail through congress in the next few months.
Based on the little polling conducted elsewhere in Latin America, medical marijuana appears to have solid public support. In Mexico, one study found a 73 percent rate of approval.
The main concern is that weed grown for medicinal purposes could end up being used recreationally. Rony Munoz, the doctor from Chile’s National Cancer Institute who prescribed Sativex to Heyder, cites allegedly lax enforcement in the US state that pioneered medical marijuana, California, as the prime example.
“It’s born out of fear that the medicines will be diverted to recreational use. We have seen that in California, but this is very different,” Munoz says. “The fears are exaggerated.”
Hannah Hetzer, a Latin America specialist at the New York-based Drug Policy Alliance, which campaigns for an end to prohibition, acknowledges the problems in California but believes the Golden State’s experience is an outlier.
“You can have medical marijuana in a very strict and regulated fashion,” she says. “One of the lessons from the US is that there doesn’t have to be a diversion [to the recreational market].”
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For Heyder, though, Chile’s new medical marijuana legislation cannot come soon enough. Although she’s now permitted to take Sativex, a new law has to be rushed through congress to allow the public health system to pay for it.
That will take at least two more months. And with Sativex treatment costing $3,000 a month, she simply cannot afford to pay for the medicine in the meantime. Gazmuri, of the Daya Foundation, says Chile should also allow marijuana research and the production of medicines locally to bring costs down.
Heyder adds: “I am very happy and grateful to the parliamentarians. But I don’t see why my case had to become so emblematic for this to change. Too many people have suffered because of this taboo.”